A randomised controlled trial of ibuprofen, paracetamol or a combination tablet of ibuprofen/paracetamol in community-derived people with knee pain

Abstract

ObjectivesTo compare the effi cacy and safety of single versus combination non-prescription oral analgesics in community-derived people aged 40 years and older with chronic knee pain. Methods A randomised, double-blind, four-arm, parallelgroup, active controlled trial investigating short-term (day 10) and long-term (week 13) benefi ts and sideeffects of four regimens, each taken three times a day: ibuprofen (400 mg); paracetamol (1000 mg); one fi xeddose combination tablet (ibuprofen 200 mg/paracetamol 500 mg); two fi xed-dose combination tablets (ibuprofen 400 mg/paracetamol 1000 mg). Results There were 892 participants (mean age 60.6, range 40-84 years); 63% had radiographic knee osteoarthritis and 85% fulfi lled American College of Rheumatology criteria for osteoarthritis. At day 10, two combination tablets were superior to paracetamol (p<0.01) for pain relief (determined by mean change from baseline in WOMAC pain; n=786). At 13 weeks, signifi cantly more participants taking one or two combination tablets rated their treatment as excellent/ good compared with paracetamol (p=0.015, p=0.0002, respectively; n=615). The frequency of adverse events was comparable between groups. However, by 13 weeks, decreases in haemoglobin (≥1 g/dl) were observed in some participants in all groups. Twice as many participants taking two combination tablets had this decrease compared with those on monotherapy (p<0. 001; paracetamol, 20.3%; ibuprofen, 19.

Pain Phenotype in Patients With Knee Osteoarthritis: Classification and Measurement Properties of painDETECT and Self‐Report Leeds Assessment of Neuropathic Symptoms and Signs Scale in a Cross‐Sectional Study

“…Radiographs obtained from the patients were scored using the Kellgren/Lawrence system, and scores of ≥2 were used to define radiographic OA. Approximately half of the patients were identified from a previous study 15, and the remaining patients were recruited from clinics in Nottingham University Hospitals NHS Trust and Sherwood Forest Hospitals NHS Foundation Trust. Exclusion criteria were another inflammatory rheumatic condition (e.g., rheumatoid arthritis, psoriatic arthritis, gout, or fibromyalgia), knee joint surgery within the last 3 months, and an inability to understand English or otherwise complete the questionnaires.…”

Use of etoricoxib in patients with gout in real clinical practice

“…Повышение максимальной дозы любо-го НПВП ничего не дает в отношении аналгезии, однако количество нежелательных явлений растет. Это относится и к сочетанию НПВП с другими НПВП и парацетамолом [5].…”

Knee Pain in Adults & Adolescents, Diagnosis and Treatment

“…NSAIDS are proven to be better at improving pain and function in osteoarthritis. The combination of paracetamol and ibuprofen is associated with significant improvements in pain relief, function and quality of life as compared to paracetamol use alone for both short and long term use [84] but at the expense of an increase in side effects, primarily GI (PPI) bleeding.…”